Ambulatory blood pressure monitoring in end-stage renal disease

BACKGROUND: Hypertension is responsible for substantial morbidity in end-stage renal disease. Ambulatory blood pressure monitoring has been used to understand the behavior of blood pressure in renal failure, especially during the interdialytic period for patients on hemodialysis. OBJECTIVE: To review the published data on ambulatory blood pressure in end-stage renal disease, with a critical focus on abnormal diurnal blood pressure rhythms, blood pressure load, and interdialytic blood pressure patterns, and to discuss clinical uses and pitfalls of this technology in monitoring the dialysis population. CONCLUSION: It seems that ambulatory blood pressure monitoring has a great potential in the research and management of hypertension in renal failure, but substantial work is still needed to ascertain its usefulness and, particularly, its prognostic ability for patients in this subset.